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G Mishra

Publications and source records attributed to G Mishra.

At least 37 records · Page 2Linked to original sources

Relationships between body mass index and well-being in young Australian women.

OBJECTIVE: To explore relationships between body mass index (BMI, kg/m2) and indicators of health and well-being in young Australian women. DESIGN: Population based cohort study--baseline cross sectional data. SUBJECTS: 14,779 women aged 18-23 who participated in the baseline survey of the Australian Longitudinal Study on Women's Health in 1996. MEASUREMENTS: Self-reported height, weight, medical conditions, symptoms and SF-36. RESULTS: The majority of women (68%) had a BMI in the range 18.5- <25; 12% had a BMI <18.5; 14% had a BMI in the range 25- <30 and 6% had a BMI > or =30. After adjustment for area of residence, age, education, smoking and exercise, women in the highest BMI category (> or =30) were more likely to report hypertension, asthma, headaches, back pain, sleeping difficulties, irregular periods, and more visits to their medical practitioner. They were also more likely to have given birth at least once, and less likely to report 'low iron'. Women with low BMI (<18.5) were more likely to report irregular periods and 'low iron'. Mean scores on the SF-36 sub-scales for physical functioning, general health and vitality were highest for women with BMI in the range 18.5-25. CONCLUSION: Acknowledging the limits of the cross-sectional nature of the data, the results show that the deleterious effects of overweight can be seen at a comparatively young age, and that BMI <25 is associated with fewer indicators of morbidity in young women. However, as BMI <18.5 is associated with low iron and irregular periods, care should be taken when developing strategies to prevent overweight in young women, not to encourage women with healthy weight to strive for a lower BMI.

Adolescent↗

EUS to detect evidence of pancreatic disease in patients with persistent or nonspecific dyspepsia.

BACKGROUND: Mild chronic pancreatitis is difficult to diagnose and the diagnosis is therefore not sought routinely in patients with dyspepsia. The aim of our study was to compare the prevalence of endosonographic pancreatic abnormalities in patients with dyspepsia and control subjects. METHODS: The number of endosonographic abnormalities was compared prospectively in patients with dyspepsia and control patients. Patients in whom there was any suspicion of pancreatic disease were analyzed separately. RESULTS: Between November 1998 and January 1999, 156 patients with dyspepsia were compared with 27 control patients. The groups were similar except that control patients were significantly older and more likely to be men. The mean number of endosonographic abnormalities was higher in dyspeptic patients than in control patients (mean number of abnormalities 3.3: 95% CI [2.9, 3.6] vs. 1.9: 95% CI [0.3, 1.7]). The strongest independent predictors of severe endosonographic abnormalities (defined as 5 or more abnormalities) were the presence of suspected pancreatic disease (odds ratio 7.29: 95% CI [2.03, 26. 14]) and dyspepsia (odds ratio 7.21: 95% CI [1.99, 26.26]). In the dyspepsia group, no clinical variables were significant predictors of severe abnormalities. However, most patients had nonspecific-type dyspepsia or persistent symptoms after therapeutic trials of acid suppression. CONCLUSIONS: Dyspepsia may be an atypical presentation of pancreatic disease in patients with persistent or nonspecific symptoms. Endosonography may be useful to screen for pancreatic disease in patients with persistent dyspepsia.

Adult↗

Leisure time physical activity in Australian women: relationship with well being and symptoms.

This paper explores the association between moderate levels of physical activity (PA) and health benefits in well being and symptoms such as tiredness, back pain, and constipation. Participants in the Australian Longitudinal Study on Women's Health, 14,502 young women (ages 18-23 years), 13,609 middle-age women (45-50 years), and 11,421 older women (ages 70-75 years), answered questions about vigorous and less vigorous exercise (used to determine a physical activity score), well being (SF-36), symptoms, and medical conditions. There were significant associations between the PA score and SF-36 in each cohort. Odds ratios (OR) for a range of symptoms and conditions were lower for women who reported low to moderate activity than for sedentary women, for example, for young women or for constipation = 0.76 (CI, 0.65-0.89), for middle-age women or for tiredness = 0.70 (0.63-0.78). There was no threshold of PA at which health benefits increased significantly. Although cross-sectional, the findings suggest that low-to-moderate levels of exercise are associated with a range of health benefits for women of all ages. These preliminary findings will be followed up during the longitudinal study.

Adolescent↗

Esophageal cancer staging: improved accuracy by endoscopic ultrasound of celiac lymph nodes.

BACKGROUND: Clinical staging of esophageal cancer is required for optimal therapy but remains imprecise. Pathologic verification of involved lymph nodes could potentially direct treatment allocation. With the rising incidence of distal and gastroesophageal junction adenocarcinomas, assessment of the celiac axis lymph nodes (CLNs) becomes important because it is a common nodal drainage basin. Endoscopic ultrasound (EUS) permits evaluation of CLNs and biopsy by fine-needle aspiration. This study examined the usefulness of this staging tool. METHODS: A consecutive series of 62 patients with esophageal cancer considered resectable by computed tomographic scan underwent EUS for T and N staging and were retrospectively studied. A CLN visualized by EUS as greater than 5 mm was considered positive. Fine-needle aspiration of the CLN was performed routinely. Endoscopic ultrasound and computed tomographic staging were compared on the basis of pathologic verification of CLNs. RESULTS: It was possible to evaluate CLNs by EUS in 59 (95%) of 62 patients: positive in 19, negative in 40. In EUS-positive patients, fine-needle aspiration was positive in 15, falsely negative in 2, and not done in 2. By computed tomographic scan, CLNs were negative in 57 patients and positive in 2. The CLNs were positive in 23 of 54 patients eligible for CLN pathologic verification. All positive CLNs not identified by EUS (7 false-negative EUS) were microscopic foci in one or two nodes and were associated with T3 tumors. Sensitivity and specificity of EUS were 72% and 97%, respectively, compared with 8% and 100% for computed tomographic scan. When EUS identified CLNs, fine-needle aspiration confirmed positivity in 88% of cases. CONCLUSIONS: Endoscopic ultrasound with fine-needle aspiration is useful in the detection and confirmation of CLN metastasis. In T3 tumors of the distal esophagus, a negative EUS result does not substantiate absence of CLN disease. Endoscopic ultrasound with fine-needle aspiration may be important in guiding treatment for patients with distal adenocarcinoma and documenting disease before neoadjuvant therapy.

Adenocarcinoma↗

Endoscopic ultrasonography with fine-needle aspiration: an accurate and simple diagnostic modality for sarcoidosis.

BACKGROUND AND STUDY AIMS: Sarcoidosis is a chronic multisystem granulomatous disease that is often diagnosed after a finding of hilar and mediastinal lymphadenopathy on a chest radiograph. This often requires further evaluation by transbronchial biopsy or other clinical parameters. The present study is a descriptive, retrospective one using endoscopic ultrasound with fine-needle aspiration (EUS-FNA) of mediastinal lymph nodes in seven patients with sarcoidosis. PATIENTS AND METHODS: Among 108 consecutive patients who underwent EUS-FNA of mediastinal lymph nodes for various clinical indications between July 1994 and October 1997, seven patients were found to have sarcoidosis on EUS-FNA, and the EUS morphology was studied in these patients. RESULTS: Sarcoidosis was diagnosed in seven patients using endosonographic characteristics and clinical follow-up. EUS with FNA showed cytological evidence of sarcoidosis in six patients. Seven patients were found to have subcarinal lymph nodes, and six patients had abnormally enlarged aortopulmonary (AP) window lymph nodes. The nodes in all patients had three endosonographic criteria for malignancy. The long axis of the largest mediastinal lymph nodes measured 3.44+/-1.42 cm (range 1.8-6.0 cm). The short axis measured 2.50+/-0.69 (range 1.0-4.0 cm). The average number of nodes seen in each patient was 2.80+/-0.75 (range 2-4). The nodes in all seven patients were discrete and well demarcated. A central hyperechoic strand was evident in these nodes in four patients (57%). There were no complications. CONCLUSIONS: Mediastinal lymph nodes in patients with sarcoidosis appear to have specific echo characteristics, and EUS-FNA can be used for confirmatory tissue diagnosis.

Adult↗

Assessment of a short scale to measure social support among older people.

BACKGROUND: Social support strongly influences health, but research has been limited by the paucity of brief, inexpensive, psychometrically sound scales suitable for use with older people. METHOD: The validity and reliability of the 11-item Duke Social Support Index (DSSI) were tested among a random sample of 565 community dwelling people aged 70 years and over. RESULTS: A response rate of 76% was obtained. Participants had a mean age of 76 years. Internal consistency using Cronbachs alpha for the overall index was 0.77. Test-retest reliability (n = 117) scores ranged from 0.70 to 0.81. Concurrent validity is supported by the DSSI's moderate to strong correlations with the Interview Schedule for Social Interaction. Construct validity of the DSSI was supported by moderate correlations with health, quality of life and loneliness. To further test construct validity a multiple regression model was used and 25.6% of the variance in social support was explained using three expected variables; self rated health, quality of life, and living arrangements. CONCLUSION: Strong evidence for reliability and validity of the 11-item Duke Social Support Index support its use in aged care research and health promotion strategies. IMPLICATIONS: The DSSI provides researchers with the opportunity to use a brief measure of social support which has been assessed specifically with older Australians instead of single-item measures or scales which have limited psychometric evidence.

Aged↗

For richer, for poorer, in sickness and in health: older widowed women's health, relationships and financial security.

AIM: This study contrasts the health and social needs of widowed older women with needs of married older women. METHOD: 12,624 women aged 70-75 years across Australia completed baseline questionnaires for the Australian Longitudinal Study on Women's Health: 34.5% of the women were widowed, and 13.5% of these widowed women had lost their spouse within the past 12 months (recently widowed). RESULTS: Recently widowed women had particular physical and mental health needs as well as financial and practical needs relating to managing on their income. They had the lowest self-rated health, were most likely to report they were stressed about their health, and scored significantly lower than married women on all 8 sub-scales of the SF-36. Women were more likely to say they make their own decisions about their life if they were widowed than if they were married. However, stress with relationships with children or other family members was more likely to be reported by widows than other women.

Aged↗

Norms for the physical and mental health component summary scores of the SF-36 for young, middle-aged and older Australian women.

The SF-36 was developed in the USA to provide an eight-scale health profile and two component summary scores representing physical and mental health. The published norms and scoring procedures are based on data from the US general population. The Australian Longitudinal Study on Women's Health (Women's Health Australia) undertook a survey in 1996 of approximately 42,000 Australian women in three age groups of 18-22, 45-49 and 70-74 years and provided age- and gender-specific norms for the SF-36 health profile. From these data, factor weights and factor score coefficients were calculated for these age- and gender-specific populations of Australian women. Thus, component summary scores for physical and mental health can now be calculated using a formula standardized to the relevant Australian population. This will facilitate the interpretation of the physical and mental health component summary scores in the Australian context and will allow meaningful comparisons within the young, middle-aged and older cohorts of Australian women in the Australian Longitudinal Study on Women's Health.

Adolescent↗

What is a healthy weight for middle aged women?

OBJECTIVE: To explore associations between body mass index (BMI) and selected indicators of health and well-being and to suggest a healthy weight range (based on BMI) for middle aged Australian women. DESIGN: Population based longitudinal study (cross-sectional baseline data). SUBJECTS: 13431 women aged 45-49 y who participated in the baseline survey for the Australian Longitudinal Study on Women's Health. RESULTS: Forty-eight percent of women had a BMI>25 kg/m2. Prevalence of medical problems (for example, hypertension, diabetes), surgical procedures (cholescystectomy, hysterectomy) and symptoms (for example, back pain) increased monotonically with BMI, while indicators of health care use (for example, visits to doctors) showed a 'J' shaped relationship with BMI. Scores for several sub-scales of the MOS short form health survey (SF36) (for example, general health, role limitations due to emotional difficulties, social function, mental health and vitality) were optimal when BMI was around 19-24 kg/m2. After adjustment for area of residence, education, smoking, exercise and menopausal status, low BMI was associated with fewer physical health problems than mid-level or higher BMI, and the nationally recommended BMI range of 20-25 was associated with optimum mental health, lower prevalence of tiredness and lowest use of health services. CONCLUSIONS: Acknowledging the limitations of the cross-sectional nature of these data, the results firmly support the benefits of leanness in terms of reducing the risk of cardiovascular disease, diabetes and gall bladder disease. The findings are moderated, however, by the observation that both low and high BMI are associated with decreased vitality and poorer mental health. The optimal range for BMI appears to be about 19-24 kg/m2. From a public health perspective this study provides strong support for the recommended BMI range of 20-25 as an appropriate target for the promotion of healthy weight in middle aged Australian women.

Australia↗

Women's Health Australia: recruitment for a national longitudinal cohort study.

The Women's Health Australia (WHA) project is a longitudinal study of several cohorts of Australian women, which aims to examine the relationships between biological, psychological, social and lifestyle factors and women's physical health, emotional well-being, and their use of and satisfaction with health care. Using the Medicare database as a sampling frame (with oversampling of women from rural and remote areas), 106,000 women in the three age groups 18-23, 45-50 and 70-75 were sent an invitation to participate and a 24-page self-complete questionnaire. Reminder letters, a nation-wide publicity campaign, information brochures, a freecall number for inquiries, and the option of completing the questionnaire by telephone in English or in the respondent's own language, were used to encourage participation. Statutory regulations precluded telephone follow-up of non-respondents. Response rates were 41% (N = 14,792), 54% (N = 14,200) and 36% (N = 12,614) for the three age groups. Comparison with Australian census data indicated that the samples are reasonably representative of Australian women in these age groups, except for a somewhat higher representation of women who are married or in a defacto relationship, and of women with post-school education. The most common reason for non-participation was lack of interest or time. Personal circumstances, objections to the questionnaire or specific items in it, and concerns about confidentiality were the other main reasons. Recruitment of three representative age-group cohorts of women, and the maintenance of these cohorts over a number of years, will provide a valuable opportunity to examine associations over time between aspects of women's lives and their physical and emotional health and well-being.

Adult↗

Food habits of young and middle-aged women living outside the capital cities of Australia.

Young (18-22 years) and middle-aged (45-49 years) women living in urban and rural areas of New South Wales completed a brief food frequency questionnaire as part of a wider health survey. Urban women in both age groups consumed meat less frequently than women in rural areas, and women in the less populated rural areas were more likely to eat green and yellow vegetables and least likely to eat dried beans. There were few other geographic differences in food habits. Middle-aged women consumed reduced-fat milk, fruit, vegetables, fish, biscuits and cakes significantly more frequently, and rice, pasta, full-cream milk, fried food and take-away food less frequently than younger women. Smokers in both age groups consumed fresh fruit, vegetables and breakfast cereals significantly less frequently than non-smokers, and women with low levels of habitual physical activity consumed fresh fruit and cereals less frequently than more active women. The findings suggest that strategies aimed at changing eating behaviours should be age-group-specific and targeted specifically to smokers and less active women.

Adolescent↗

Possible role of lens collagen in cataractogenesis.

The solubility characteristics of collagen in human cataractous eye lenses were studied in relation to age. Post-operative cataractous lenses were collected form eye camps in Phulbani district of Orissa. These were preserved in 70% alcohol and immediately transferred to the laboratory. Various fractions in the collagen obtained from lens capsule of each lens sample were estimated. The salt-soluble and the acid-soluble collagens showed positive correlation with age. The insoluble and total capsular collagen increased with increasing age. The solubility percentage of collagen in salt and acid solutions decreased significantly with increasing age. The possible role of lens collagen in the development of cataract with increasing age is discussed in the background of cross-link theory of aging.

Adult↗

Alloxan diabetes in Swiss mice: activity of Na(+)-K(+)-ATPase and succinic dehydrogenase.

The activities of two enzymes viz: Na(+)-K(+)-ATPase and succinic dehydrogenase (SDH) in brain and liver of alloxan diabetic Swiss albino mice are reported. Alloxan diabetes caused significant decrease in the activity of Na(+)-K(+)-ATPase reflecting reduced glucose transport across the cell membrane. On the contrary, the observed enhanced activity of the enzyme SDH is attributed to increased supply of TCA cycle substrates from accelerated oxidation of fatty acids.

Animals↗

In vitro effect of alloxan on Na(+)-K(+)-ATPase and succinate dehydrogenase activities in brain and liver of mice.

The present study reports in vitro inhibition of the activities of enzymes Na(+)-K(+)-ATPase and succinate dehydrogenase by alloxan in brain and liver homogenates of Swiss mice. The Vmax of both the enzymes was reduced in presence of alloxan without any substantial alteration in Km for substrate. Lineweaver Burk's plots showed higher 1/Vmax for alloxan treated samples and convergence of both slopes to intercept-1/Km. The observations pointed to non-competitive type inhibition of the enzymes by alloxan. This may be due to the modification of essential--SH groups present within/adjacent to substrate binding sites by alloxan.

Alloxan↗